Periton Diyalizine Yeni Başlayan Hastaların Retrospektif Değerlendirmesi

Abstract

Amaç:

Periton diyalizine 2016-2017 yılları arasında yeni başlayan hastaların periton diyalizine ilişkin durumlarının incelenmesidir.

Gereç ve Yöntemler:

Araştırmanın evrenini Amasya (n=12) ve Sivas (n=16)’ta yer alan periton diyaliz ünitesindeki hastalar, örneklemini ise 2016-2017 yılında PD’ye yeni başlayan hastalar (n=17) oluşturdu.  Veriler Türk Nefroloji, Diyaliz ve Transplantasyon Derneği Registry raporu rehber alınarak hazırlanan “PD hasta değerlendirme formu” aracılığıyla retrospektif olarak elde edildi.

Bulgular:

Son iki yılda PD tedavisine yeni başlayan merkezde 12 hasta, 20 yıldır PD uygulayan üniversitede ise 5 hastaya PD kateteri takılmıştır. Hastaların %41.1’inin etiyolojisinin diyabetik nefropati olduğu, %52.9’unun membran tipinin düşük-orta geçirgenlikte olduğu, %70.5’inin Kt/V üre değerinin 2’nin üstünde olduğu, %76.4’sinin serum albumin değerinin 3.5-4 aralığında olduğu, %41.1’inin tansiyonun normal sınırlarda olduğu, %52.9’unun kalsiyum kanal blokeri kullandığı, %70.5’inin Hb değeri 10.0-11.9gr/dl olduğu saptandı. Hastaların %94.1’inin demir ilacı kullanmadığı, %52.9’ünün eritropoetin kullandığı, %35.2’si ise halen kullanmakta idi.  %52.9’ünün serum fosforunun 4.5-5.49 mg/dl, %41.17’sinin PTH düzeyi 301-600 pg/ml arasında olduğu, hiçbir hastada kırık gelişmediği saptandı. Hastaların peritonit geçirmediği ve %47’inin ultrafiltrasyon sorunu yaşadığı,  %11.76’sının mekanik komplikasyon nedeniyle hemodiyalize transfer olduğu saptandı.  Hastaların kontrole geldiklerinde sıklıkla yakınmaları iştahsızlık, bulantı kusma, ödem ve halsizlikdi. Hemşireyi telefonla arama nedenlerinin sıklıkla drenaja yönelik problemler, oral ilaç kullanımı, PD makinası ve kateter ile ilgili sorunlardı.

Sonuç:PD hastalarında hipoalbunimeni, hiperfostatemi, anemi, bulaşıcı hastalık, kırık ve peritonit gibi ciddi komplikasyonlar gelişmediği saptandı.Bu durum periton diyaliz tedavisini avantajlı kılmaktadır.

Keywords

• Periton diyalizi,Periyon diyaliz etiyolojisi

References

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